Provider Demographics
NPI:1639912124
Name:MCDERMED, NICHOLAS (LPC)
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:
Last Name:MCDERMED
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:NICK
Other - Middle Name:
Other - Last Name:MCDERMED
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:3033 W 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-4790
Mailing Address - Country:US
Mailing Address - Phone:434-249-1757
Mailing Address - Fax:
Practice Address - Street 1:3033 W 4TH AVE
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-4790
Practice Address - Country:US
Practice Address - Phone:434-249-1757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-13
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0017292101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health